Do I need to stop taking propranolol before having lipo and tummy tuck?

Question

I take 60mg ER propranolol for hormone related(menopause) tachycardia /palpitations. Do I need to stop the medication before surgery if I'm having lipo and tummy tuck?

Semih Yildiz, MD, FEPOBRAS · Answer

You should not stop propranolol on your own before surgery. Beta blockers are often continued through the perioperative period because suddenly stopping them can cause rebound fast heart rate, palpitations, or elevated blood pressure. That said, the exact plan should come from your prescribing doctor, surgeon, and anesthesia team, because they need to know why you take it, your heart history, your usual blood pressure and pulse, and the length and extent of the planned tummy tuck and liposuction.

At your preoperative visit, tell the anesthesia team that you take 60 mg extended-release propranolol for tachycardia/palpitations. They may ask for medical clearance, an EKG, or input from the clinician who prescribed it, especially if the palpitations have not been fully evaluated or controlled. Many patients are instructed to take their beta blocker the morning of surgery with a small sip of water, but that instruction should be individualized.

Also make sure your team reviews all other medications and supplements, because some items do need to be held before surgery. The safest approach is coordinated medication instructions in writing rather than stopping propranolol without guidance.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the use of propranolol and its impact on your upcoming surgery. Propranolol is a beta-blocker commonly prescribed to manage conditions such as tachycardia or palpitations, and in your case, it appears to help with hormone-related symptoms due to menopause. Whether or not to stop propranolol before surgery is an important discussion to have with your surgeon and anesthesiologist.

In most cases, propranolol does not need to be discontinued before surgery. Abruptly stopping a beta-blocker could lead to rebound effects, such as increased heart rate or blood pressure, which could complicate your procedure. Instead, it’s generally safer to continue the medication, but there are a few considerations to keep in mind. You should ensure that your surgical team is fully aware of your propranolol use so they can plan for any necessary adjustments during the procedure.

Your anesthesiologist will monitor your heart rate and blood pressure closely during surgery because propranolol affects cardiovascular function. This monitoring ensures that you remain stable throughout the procedure. In rare cases, adjustments to your dosage may be considered, but this will depend on your individual health profile and the specifics of your surgery.

Your plastic surgeon may also request preoperative tests, such as an EKG to assess your heart function and bloodwork to check for any potential issues like anemia or electrolyte imbalances. These tests are standard for patients undergoing surgery and help ensure that you’re in optimal health for the procedure.

Postoperatively, continuing propranolol can often be beneficial. It helps manage stress-induced heart rate increases and promotes a smoother recovery. Additionally, propranolol’s mild calming effects may help ease postoperative pain and anxiety.

Ultimately, it’s unlikely you’ll need to stop propranolol before surgery, but clear communication with your medical team is essential. Discuss your medication with both your surgeon and your prescribing doctor to ensure everyone is on the same page. Following their recommendations will help minimize any risks and ensure a safe and successful surgical outcome.

Sincerely,
Dr. Katzen

Robert M. Wald, Jr., MD · Answer

You should check with your family doctor, but in most cases, you should continue to take this medicine. This medicine should not interfere with the surgery or anesthesia. Anti inflammatories and any blood thinners must be stopped 2 weeks before surgery.

Daniel Barrett, MD · Answer

Dear Persistent8999,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Derek Fletcher, MD · Answer

We instruct most patients to stop taking their blood pressure medications (especially beta blockers like propranolol) the day of surgery because the general anesthetic frequently lowers blood pressure and can cause slowed heart rate as well.

Mahira Tanovic, MD · Answer

Hello,
This is a great question! It is always best to ask your surgeon questions related to stopping/starting medications. It is also always wise to have a medical clearance appointment with your primary care provider to address all of these questions and concerns prior to surgery. You may also want to discuss with the provider who has prescribed you the medication you are taking, so that all your providers are on the same page and up to date on your case!
Best,Dr. Tanovic

John L. Burns Jr., MD · Answer

you need to check with your primary care physician, plastic surgeon, and anesthesiologist.  They can guide you based on your particular case.

Ronald J. Edelson, MD · Answer

This would be a question for your surgeon and anesthesiologist. I don’t think there’s a right or wrong answer so address it to your doctors and follow their directions

Eric W. Anderson, MD · Answer

Propranolol is a type of beta blocker and there is strong peri-operative data showing patients should maintain beta blocker dosing around surgery. This would be my preference as a surgeon. That being said I strongly urge you to have the same discussion with your surgeon and anesthesia provider !

Heather Vande Ven, DO · Answer

Propranolol is a beta-blocker commonly used to treat conditions such as high blood pressure, angina, and certain heart rhythm disorders. Before undergoing any surgical procedure, including liposuction and tummy tuck (abdominoplasty), it is important to inform your plastic surgeon about all the medications you are taking, including propranolol.In some cases, healthcare providers may recommend adjusting or discontinuing certain medications before surgery to reduce the risk of complications or interactions. However, abruptly stopping propranolol can have potential side effects, and it is essential to manage any changes in medication under the guidance of your healthcare team.Your plastic surgeon and anesthesiologist will consider your overall health, the specific procedure you are undergoing, and any potential interactions between propranolol and anesthesia or other medications used during surgery. They will provide specific instructions regarding when and how to adjust your medication, if necessary.It is crucial to communicate openly with your healthcare team and follow their recommendations to ensure a safe and successful surgical experience. Always consult with your healthcare provider to get recommendations based on your individual health circumstances.

Do I need to stop taking propranolol before having lipo and tummy tuck?

Answers (16)

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